Protective Services Research Articles

Analisis Perlindungan Hukum Terhadap Anak Korban Kekerasan Seksual di Dinas Pemberdayaan Perempuan dan Perlindungan Anak Kota Tanjungbalai

The aim of this research is to find out how the Office of Women's Empowerment and Child Protection has attempted to implement legal protection in accordance with Law Number 35 of 2014 concerning Amendments to Law Number 23 of 2002 concerning Child Protection against cases of sexual violence against children, as well as to find out efforts made by the Tanjung Balai City Women's Empowerment and Child Protection Service to help child victims of sexual violence. This research was conducted at the Women's Empowerment and Child Protection Service in Tanjungbalai City, North Sumatra. The method used in this research is a qualitative descriptive research method. The qualitative descriptive method has the main characteristics, namely conducting research involving direct involvement in the field, acting as an observer, creating categories of actors, observing phenomena, recording them in an observation book, not manipulating variables, and focusing on scientific observation. The data collection technique used to obtain data is through interviews and documentation. The results of this research found that the efforts of the Tanjung Balai City Women's Empowerment and Child Protection Department have been running optimally, in accordance with Law Number 35 of 2014 concerning Amendments to Law Number 23 of 2002 concerning Child Protection against cases of sexual violence against children. The form of legal protection used is in the form of preventive and repressive legal protection. One of the programs being implemented is synchronizing and coordinating the prevention of violence against children, which is expected to reduce the number of cases of sexual violence against children in Tajung Balai City.

Associations between child protective services workers’ attitudes toward kinship foster care placement, sociodemographic characteristics, and job characteristics

ABSTRACT When necessary to separate children from their parents, placing a child with kin leads to better outcomes. Child Protective Services (CPS) staff attitudes toward kinship foster care placements are an understudied factor that may influence decision-making and vary based on staff characteristics. Using February 2023 survey data from 2,861 CPS staff and multivariate linear regression analyses, we assessed associations between staff’s sociodemographic and occupational characteristics and attitudes toward kinship placement. Gender, race, position, work unit, and employment duration with CPS were significantly associated with staff attitudes. Understanding how staff view kinship placement is an important step toward removing barriers to its use.

Agency support for at-risk families: service provision, challenges and effective elements for intervention

ABSTRACT There is an urgent need to locate effective interventions for parents involved with child protection services (CPS), Oranga Tamariki in Aotearoa New Zealand. This article describes a qualitative research study that sought to understand: (1) the nature of service provision to families; (2) workers’ perceptions of challenges and effective treatment components in delivering intervention; and (3) effective practices for working with Māori. Participants were staff members working within NGOs, providing interventions to families with ongoing Oranga Tamariki involvement. Data comprised responses to semi-structured interviews (n = 9), interpreted using thematic analysis. Findings highlighted that all participants worked within family homes to deliver intervention, and drew on Te Whare Tapa Whā. Challenges included ongoing child maltreatment concerns and participants’ sense of responsibility for keeping children safe whilst being unable to do so adequately within their non-mandated roles. Perceived effective elements were: strong relationships, transparency, and having courageous conversations when needed. For indigenous clients, self-determination and the effects of colonisation were of prime importance. Themes highlighted responsive practice, with a pragmatic understanding that family priorities may not always align with professional views. This is consistent with international findings regarding challenges in delivering parenting interventions and identifies potential essential components for effective practice. HIGHLIGHTS Practitioners’ perceptions of essential elements to effective practice included: strong relationships, honesty, reciprocity, and directness regarding child protection concerns. Effective practices seen to be particular to working with Māori families were trusting, reciprocal relationships and ensuring self-determination and autonomy. Ethical tensions and a sense of complicity and helplessness at times were described, with ongoing child protection concerns evident during intervention for some families. Practitioners took a holistic approach to their work, expressing non-judgment, sympathy for, and understanding of the complex circumstantial and personal challenges faced by Oranga Tamariki-involved parents. Glossary of Māori terms: awhi: embrace, cherish; kaimahi: staff members; kanohi ki te kanohi: face to face; karakia: blessing; kaupapa Māori: Māori approach; kete: basket; kōrero: to speak; mana: prestige; manaakitanga: hospitality; mana whenua: people with rights over the land; marae: meeting house; Pākehā: New Zealander of European descent; pepeha: introduction; pēpi: baby; pono: true; pōwhiri: welcome ceremony; tamariki: children; tangata: people; tika: correct; tikanga: custom; tutū: mischevious; waiata: song; whakapapa: genealogy; whānau: family; whanaungatanga: relationship; whare: house.

Maternal Downward Neighborhood Income Mobility and Newborn Discharge to Child Protective Services

This cohort study examines whether there is an association between a mother moving into a neighborhood with lower income between births and newborn custody by child protective services at birth.

Gendered administrative burden: regulating gendered bodies, labor, and identity

Abstract Gendered burdens are experiences of coercive and controlling state actions that directly regulate gendered bodies, labor, and identity. Burdens are not simply about preventing access to rights and benefits, they're about control and coercian. Gendered burdens generate gender inequality through four mechanisms. First, administrative burdens regulate reproductive bodies, legitimating the state’s direct control over reproductive health care, including abortions, with consequent implications for peoples’ health. Second, burdens require reproductive labor, shifting unpaid and underpaid reproductive labor onto women as the policies that support such labor tend to have high administrative burdens that impede access. Third, gendered burdens restrict reproductive labor, impeding the right to provide such care labor with dignity, by exerting control over how, and sometimes whether, care is performed, including in rights-granting venues, like redistributive benefits, and rights-depriving venues, like the supervision of families by child protective services. Fourth, burdens regulate gendered identities, reinforcing heteronormative and cis-normative constructions of gender, including by directly controlling gender identification. While gendered burdens are not only experienced by women, they are most strongly applied to poor and racially marginalized groups of women. These claims provide a basis for public administration scholarship to connect with feminist theory by illustrating the centrality of administrative processes and related experiences to structural patterns of inequality.

23 Probing bias: Understanding the experiences of Black, Indigenous and People of Colour (BIPOC) caregivers for children with developmental disabilities and their involvement with child protection

Abstract Background In Canada and abroad, a disproportionate number of Black Indigenous and Persons of Colour (BIPOC) experience referral to child protective services (CPS). Children with developmental disabilities, including Autism Spectrum Disorders (ASD) and intellectual disabilities (IDD), are also disproportionately CPS-involved. Recent Canadian research has suggested that almost a quarter of children from a complex care paediatric program are CPS-involved, however there is no known research for ASD/IDD populations seen in a general paediatric clinic. Further, intersections of race/ethnicity and ASD/IDD and CPS involvement have not been examined. Objectives We are conducting a mixed methods study to explore the intersections of race, developmental disabilities and involvement with CPS for our paediatric population. Design/Methods Phase 1: We completed a retrospective cohort study of 349 patients (0-18 years of age) who were seen by a paediatrician and social worker at a large, hospital-based paediatric clinic in Toronto, Canada in 2019. Electronic medical record data was reviewed and the following binary variables (yes/no) coded CPS-involved or referral made, 1+ caregiver identify as BIPOC, and primary language of caregiver(s) not English. Results Preliminary analyses indicate that 11.7% of our sample is CPS-involved. Contrary to over-representation of BIPOC families in the general CPS population, we found that the proportion of families involved with CPS was lower for BIPOC than non-BIPOC families. A similar pattern was observed for primary language, with a trend towards caregivers who reported English as a second language being less likely to be CPS-involved. In our presentation, we will present analyses regarding the type and intensity of CPS involvement and include other demographic characteristics of the family. These findings will be interpreted with findings from Phase 2 (currently underway), which explores lived experiences of 40 caregivers involved with CPS drawn from Phase 1. Conclusion Within an ASD/IDD patient sample, BIPOC families were less likely to be involved with CPS than non-BIPOC families. This finding is in stark contrast to provincial rates that suggest a 2.2 times greater likelihood of CPS-involvement for Black youth. While these results on the surface suggest equity, they may still reflect bias. It is possible that the concerns of BIPOC families are being downplayed in comparison to non-BIPOC families, reducing their access to supportive services.

Mental health-related hospitalisations of adolescents and their contact with child protection services to age 11 years, South Australia: a whole-of-population descriptive study.

To investigate the number of mental health-related hospitalisations of adolescents (12-17 years) in South Australia by level of contact with the child protection system (0-11 years). Whole-of-population descriptive study; analysis of de-identified linked administrative data from the Better Evidence Better Outcomes Linked Data (BEBOLD) platform. Adolescents born in South Australia, 1991-1999; linked SA Department for Child Protection, Admitted Patient Care (SA Health), and South Australian Perinatal Statistics collection (SA Department for Health and Wellbeing) data. Proportion of adolescents (12-17 years) hospitalised with mental health-related diagnoses; proportion of mental health-related hospitalisations of adolescents, by level of child protection contact (0-11 years) (no contact, notification but not screened in, screened-in notification but not investigated, investigation but not substantiated, substantiation, and out-of-home care). Of 175 115 adolescents born during 1991-1999, 5646 (3.2%) had been hospitalised with mental health conditions, and 27 203 (15.5%) had histories of contact with child protection services. The proportion of adolescents admitted to hospital with mental health-related diagnoses increased with the level of prior child protection contact, from 3366 of 147 912 adolescents with no contact (2.3%), to 398 of 6645 with notifications (6.0%), to 209 of 1191 who had been placed in out-of-home care (17.5%). Contact with child protection services was recorded for 2280 of 5646 adolescents admitted to hospital with mental health-related diagnoses (40.4%); 4477 of 10 633 mental health-related hospitalisations (44.9%) were of adolescents with histories of child protection services contact, including 1285 hospitalisations (12.1%) of adolescents for whom substantiated maltreatment (but not out-of-home care) was recorded, and 568 hospitalisations (5.3%) of adolescents who had been placed in out-of-home care. About 45% of mental health-related hospitalisations of 12-17-year-old adolescents were of people who had had contact with child protection services by the age of 11 years, although only 15.5% of all adolescents had histories of child protection contact. The trauma associated with a history of child protection can have longer term sequelae, and this should be considered when adolescents are hospitalised with mental health conditions.

A public health/hospital partnership to improve Emergency Department transitions of care for vulnerable older adults.

Community-dwelling older adults are at high risk for unmet social service needs. We describe a novel partnership embedding county services case managers in the Emergency Department (ED) to connect older adults to community services alongside their medical care. Setting: A medium-sized urban ED with 55,000 patient visits a year. Case managers from the Franklin County, Ohio Office on Aging (OA) were embedded within the ED. The OA team worked with the ED social work team to identify community-dwelling older patients, perform an in-person intake assessment, and initiate needed community services (including home-delivered meals, emergency response systems, house repairs, and transportation). Program logic model and development are reported in detail. From June to December 2023, there were 7284 ED visits for adults ≥60 years old. Referrals to the OA case manager ranged from 1 to 13 per day. The OA case managers performed 252 full intake assessments on unique patients. The population was 51% men. Only 11% (n = 28) were currently connected to OA services, and of those already connected 29% (n = 8) needed increased services. Of the remaining unconnected patients (n = 224), 8% (n = 20) were not county residents and the OA team connected them with other county OAs. Half 53% (n = 120) were accepting of services and had services from the OA or other community health programs initiated during the ED visit. The OA team made three new Adult Protective Services referrals and one referral to the long-term care ombudsman. The program did not increase ED length of stay or hospital admission rates. Embedding county service enrollment within a community ED is a cost neutral intervention that reached a population without previous services. Future plans include expansion of the program and evaluation of the program's ability to detect elder mistreatment and self-neglect.

Legal Involvement in Pediatric Cancer Treatment Refusal: A Qualitative Study.

To characterize the spectrum of legal options considered in cases of treatment refusal, nonadherence, and abandonment (TRNA); clinicians' thought processes regarding legal intervention; and perceived consequences of legal involvement. We conducted in-depth, semistructured interviews with 30 pediatric oncologists between May and September of 2019 regarding experiences with TRNA. The interview guide covered types of conflicts encountered; factors and strategies considered in response; effects of TRNA cases, personally and professionally; the role of ethical frameworks and legal requirements; and resources needed to manage TRNA cases. Interviews were transcribed and coded iteratively using thematic analysis. Participants represented a range of institutional sizes, geographic locations, and years in practice. Twenty-five of 30 interviewees discussed legal consideration with regard to TRNA. Most participants first engaged the legal system through child protective service agencies. They considered patient age, treatment efficacy, quality of life (burden of treatment), and prognosis; family resources and social context; and preservation of therapeutic relationships and possible consequences of reporting. Experiences and outcomes of legal involvement varied. Clinicians struggle with the tension between obligations to report medical neglect and fears that reporting may result in more harm than benefit to the child in question. We urgently need more dialog between health care professionals and child protective services and legal professionals. Stakeholders from both groups would benefit from a greater understanding of the other's thought processes; clarity regarding the relevant facts; and mutual progress toward creative, evidence-based solutions to working out these complex challenges.

What Happens When Child Abuse Pediatricians and CPS Investigators Collaborate? A Study of the Multidisciplinary Pediatric Education and Evaluation Consortium.

The Multidisciplinary Pediatric Education and Evaluation Consortium (MPEEC) is a medically directed program that mandates real-time interagency collaboration among child abuse pediatricians (CAPs), child protective services (CPS) investigators, and law enforcement. MPEEC provides consultation resulting in a definitive medical opinion regarding manner of injury when allegations of serious harm involving children less than three years old living in Chicago are reported to Illinois Department of Children and Family Services (DCFS). This study is the first to link data from a medically directed, inter-agency program with CPS investigations data to specifically examine the duration of CPS investigations and the level of concordance between the manner of injury as determined by CAPs and the investigation's outcome when CPS investigators and medical professionals are required to formally collaborate. On average, MPEEC produced a written opinion 16days from the time of referral and DCFS made a finding 45days after receiving the MPEEC report for the 690 cases referred to MPEEC over a 3-year period. The concordance level ranged from 75-90%. Our results highlight the need for more analysis of linked data to promote efficiency and proficiency in CPS investigations.

Removal of Isolated Cannabis Use as an Order Indication for Urine Drug Screening (UDS) Eliminates Racial Inequity in Maternal UDS Testing and Reporting to Child Protective Services

Abstract Black patients on labor and delivery (L&D) units are more likely to undergo urine drug screening (UDS) and subsequent mandated reporting to child protective services (CPS), which can result in increased separation of the parent and infant, contributes to systemic inequities, and erodes the patient/provider relationship. These disparities are driven by a testing indication of isolated cannabis use (ICU), which based on previous data from our institution, disproportionately selects Black patients for testing. In October 2022, the Barnes-Jewish Hospital (St. Louis, MO) L&D unit removed ICU as a UDS indication; concurrently, we implemented an electronic health record (EHR)-based order question requiring providers to select an indication for testing. The objective of this study was to analyze the impact of this intervention on racial equity in UDS testing and CPS reporting. Data on deliveries, UDS testing, and CPS reports were obtained from the EHR, and data for deliveries occurring during the pre- (1/1/2020-9/30/2022; 33 months) vs. post-implementation (10/1/2022-2/1/2024; 16 months) periods was compared. There were a total of 9,187 and 4,757 deliveries during the pre- and post-implementation periods, respectively. At baseline, there were more deliveries by Black patients in the pre-implementation (47.8%) vs. post-implementation (44.0%) period (p<0.001); there was no difference in age, multiparity, or neonatal outcomes between the two periods. In the pre-intervention period, 29.2% of Black and 13.8% of White patients had UDS testing (p<0.001), and 7.6% of Black and 4.1% of White patients underwent reporting to CPS (p<0.001); in the post-intervention period, 4.5% of Black and 3.6% of White patients had UDS testing (p=0.52), and 4.2% of Black and 3.5% of White patients underwent reporting to CPS (p=0.52). 34.6% vs. 67.8% of UDSs in the pre- and post-implementation were positive for any non-cannabis compound, respectively (p<0.001). In conclusion, removing ICU as an order indication dramatically improves racial equity in UDS testing and CPS reporting on a L&D floor, and improves the pre-test probability of UDS testing for non-cannabis compounds.

Transparency and high-value datasets environmental at the service of environmental protection

Transparency and high-value datasets environmental at the service of environmental protection

Prevalence of COVID-19 and Long COVID by industry and occupation: Behavioral Risk Factor Surveillance System 2022.

Workers in healthcare and other essential occupations had elevated risks for COVID-19 infection early in the pandemic. No survey of U.S. workers to date has comprehensively assessed the prevalence of both COVID-19 and Long COVID across industries and occupations (I&O) at a detailed level. Behavioral Risk Factor Surveillance System data for 2022 from 39 states, Guam, and the U.S. Virgin Islands were used to estimate prevalence of self-reported history of COVID-19 and Long COVID, as well as the prevalence of Long COVID among those reporting prior COVID-19, by broad and detailed I&O. Adjusted prevalence ratios were used to compare outcome prevalence in each I&O to prevalence among all other workers combined. By broad I&O, workers in healthcare, protective services, and education had elevated prevalences of COVID-19. The prevalence of Long COVID was elevated in healthcare and protective service but not education workers. Detailed I&O with significantly elevated prevalences of COVID-19 but not Long COVID included Dairy Product Manufacturing industry workers and subsets of mining workers. Both COVID-19 and Long COVID were elevated among bartenders/drinking places and personal care and appearance workers. The prevalence of Long COVID was elevated among farmworkers who reported having had COVID-19. Industries and occupations with elevated levels of COVID-19 or Long COVID in this study may warrant increased measures to prevent transmission of airborne respiratory viruses. Accommodations are a key component for supporting workers in all workplaces. This new information about the distribution of Long COVID by I&O suggests where employer understanding and implementation of tailored workplace supports and accommodations are most needed to support continued employment of affected workers.

Perception of father absence in family assessment and intervention: are they not involved because they don’t want to be?

ABSTRACT Child protection services intervene with mothers, leaving fathers on the sidelines. However, fathers’ involvement is beneficial. The aim is to explore fathers’ and professionals’ perceptions of the factors influencing fathers’ involvement in family assessments and interventions. A qualitative design was used and 5 focus groups with 9 professionals, 10 mothers and 8 fathers, and 6 in-depth interviews with 6 fathers were carried out in Gran Canaria (Spain). A thematic content analysis was carried out using QSR NVivo 12. The category Determinants of paternal involvement in family assessment and intervention was obtained, made up of 3 subcategories: Personal characteristics of the father, Social characteristics and Influence of the mother on the father’s decision. Fathers claim that fathers’ personal characteristics condition their involvement, while professionals argue that it is due to mothers’ influence. Implications for professional practice and work with men are discussed. This study is part of a funded research project.

Integrating health and child protection systems: towards collaboratively improving health outcomes for children in kinship care in rural Australia

PurposeThere is a growing recognition that the integration of health systems will benefit children in out-of-home care (OOHC), especially those who have experienced trauma. This paper examines the adaptation of existing health systems and the persistent barriers between rural health and child protection programs. It focuses on health systems integration for children aged 0–6 years in kinship care and their siblings.Design/methodology/approachThe study applied a multi-methods qualitative approach involving individual interviews and focus groups with project members from operational or strategic reference groups, child protection personnel and the kinship carer program. We also reviewed documentary evidence.FindingsWe found evidence that health clinicians and child protection practitioners adapted and adjusted services as they collaboratively worked together to improve care delivery to children in kinship care. Yet, despite successful adaptations to systems and the appointment of a health navigator, systemic barriers remain. These include service and staff shortages in rural Australia, complications around information sharing, authority and power dynamics and siloed operations. Such barriers prevent better-integrated health systems and ultimately impair health outcomes for children in kinship care.Originality/valueThis paper contributes to knowledge and practice to improve the integration of child protection and healthcare services in Australian OOHC. It provides valuable insights into the challenges and successes of health systems integration, highlighting the need for continued collaborative effort to create effective, place-based models of care that benefit these children and their carers.

CPS response and service factors for the child maltreatment recurrence in South Korea

ABSTRACT This study examined whether the response and service characteristics of Child Protective Services (CPS) in Korea are different between the initial reports and subsequent reports in the context of child maltreatment recurrence and to identify the CPS system factors at initial reports associated with the first recurrence and the second recurrence. Study results from 7,544 maltreatment cases show that children and families of maltreatment recurrence were likely to have more emergency separation, legal action, case closure, out-of-home placement, in-home services, and counselling services for subsequent reports compared to initial reports. Also, reporter type, time to disposition decision, out-of-home placement, caregiver receiving mental health therapy, in-home services, and counselling for family members were associated with the risk of the first recurrence and a number of field visits for investigation and mental health therapy for family members were associated with the risk of the second recurrence. Implications were discussed based on the study findings.

What are the Factors Influencing Service Provider Response to Working with Families Affected by Intimate Partner Violence and Abuse? A Qualitative Systematic Review of the Literature

Abstract Purpose Intimate partner violence and abuse (IPVA) is a major public health issue with long-term negative impacts on abused adults and affected children. Addressing this complex problem requires a multi-agency response, but barriers to effective joint working remain. This review aimed to understand the factors that influence multi-agency response to families who experience IPVA and to their children. Method We undertook a qualitative systematic review of international literature via five electronic databases and supplemented the review by citation searches, online searches of grey literature, and hand searches of relevant journals. We analyzed data thematically. Results The 31 identified papers reported findings from 29 unique studies undertaken in six countries and drew on data from 1049 professionals across health care, social care, the police, courts, schools and voluntary organisations. The main factors influencing service provider response to IPVA were siloed approaches to IPVA, particularly the separation between adult and childrens services. This influenced assessment and response to risk. Risk was also a consideration when child-protection staff were expected to work with perpetrators in ‘family settings’, even in lower-risk cases. Multi-agency working facilitated information sharing between agencies, an understanding of each other’s remit, and building trust. Conclusion Multi-agency collaboration needs to be supported by clear policies of interaction between agencies. Providers of child protection services, health, mental health, housing police and probation need to be supported by specialist training in IPVA, not only in high-risk cases, but also to relieve pressure on an already overstretched workforce.

Transnational professionalism in child welfare in Germany

The field of child protection is closely interwoven with the national welfare state and its institutions. Nowadays, both the everyday lives of families and the professional work are shaped by transnational activities. This article presents the results of a study on child protection services in Germany working across national borders. Although regulated by international law, there are institutional and organisational gaps challenging professionals in this field. We can find processes of border setting and border crossing by professional social workers at the same time. Two ideal types of transnational situations are presented that reflect the variations of professional activities.

Client Violence and Emotional Health Among Child Protection Services Workers

Client Violence and Emotional Health Among Child Protection Services Workers

Prenatal Substance Exposure and Infant Discharge Placement: Results From the ACT NOW Study.

It is critical that researchers gather evidence of factors that identify infants at risk of out-of-home placement based on types of substance exposures and demographic characteristics. This study applied a validated medical record data extraction tool on data derived from a multi-site (N = 30) pediatric clinical trials network (ISPCTN) study of Neonatal Opioid Withdrawal (ACT NOW study). Participants included 1808 birthing parent-infant dyads with documented NOWS scoring or prenatal opioid exposure. Non-Hispanic White pregnant persons comprised the largest proportion of the sample (69.8%), followed by Non-Hispanic Black (11.6%), Non-Hispanic Multiracial and Other race (8.5%), and Hispanic (6.2%). Most notably, infant prenatal substance exposure across alcohol, cocaine, meth/amphetamine, and opioids, had the lowest possibility of discharging to parent(s). Additionally, latent class analysis identified distinct classes of substance use during pregnancy that were associated with different probabilities of discharging to parent(s). Specifically, less than half of infants (47%-49%) in the Poly-use and Meth/amphetamine classes were discharged to their parent(s). Severity of infant withdrawal symptoms influenced placement decisions within the Poly-use and Prescription Opioid classes. Findings can inform standard practices for increasing support for pregnant persons and substance-exposed infants including identification, subsequent referrals, communication with Child Protective Services, and plans of safe care.